Journal of Pediatric Intensive Care, Table of Contents J Pediatr Intensive Care 2020; 09(02): 113-118DOI: 10.1055/s-0039-1700981 Original Article Georg Thieme Verlag KG Stuttgart · New YorkEffect of Potassium Infusions on Serum Levels in Children during Treatment of Diabetic Ketoacidosis Sangita Basnet 1 Division of Critical Care, Department of Pediatrics, Southern Illinois University School of Medicine, Springfield, Illinois, United States , Rawan Musaitif 2 Department of Pediatrics, University of Illinois College of Medicine at Peoria, Illinois, United States , Aayush Khanal 1 Division of Critical Care, Department of Pediatrics, Southern Illinois University School of Medicine, Springfield, Illinois, United States , Kimberly Powell 1 Division of Critical Care, Department of Pediatrics, Southern Illinois University School of Medicine, Springfield, Illinois, United States , Giovanna Caprirolo 1 Division of Critical Care, Department of Pediatrics, Southern Illinois University School of Medicine, Springfield, Illinois, United States , Ryan Majcina 1 Division of Critical Care, Department of Pediatrics, Southern Illinois University School of Medicine, Springfield, Illinois, United States , Randall S. Robbs 3 Center for Clinical Research, Southern Illinois University School of Medicine, Springfield, Illinois, United States› Author AffiliationsRecommend Article Abstract Buy Article Abstract A retrospective study was done to determine the effect of potassium (K+) infusions on serum levels in children admitted to the pediatric intensive care unit (PICU) with diabetic ketoacidosis (DKA). Eighty-two percent of 92 cases studied received 40 mEq/L K+ infusion over the treatment period of median 13.0 (interquartile range [IQR]: 7–18) hours. The median K+ value at the end of this period was 3.9 (IQR: 3.4–4.2) mEq/L. There were 31 data points of low K+ values (<3.5 mEq/L) and 4 high values (>5.5 mEq/L) during this treatment period. The K+ infusions of 40 mEq/L may be sufficient to normalize serum K+ when treating DKA. Keywords Keywordspediatrics - diabetic ketoacidosis - potassium infusion Full Text References References 1 Wolfsdorf JI, Glaser N, Agus M. , et al. ISPAD Clinical Practice Consensus Guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes 2018; 19 (Suppl. 27) 155-177 2 Liamis G, Liberopoulos E, Barkas F, Elisaf M. Diabetes mellitus and electrolyte disorders. World J Clin Cases 2014; 2 (10) 488-496 3 Adrogué HJ, Lederer ED, Suki WN, Eknoyan G. Determinants of plasma potassium levels in diabetic ketoacidosis. Medicine (Baltimore) 1986; 65 (03) 163-172 4 Nabarro JD, Spencer AG, Stowers JM. Metabolic studies in severe diabetic ketosis. Q J Med 1952; 21 (82) 225-248 5 Atchley DW, Loeb RF, Richards Jr DW, Benedict EM, Driscoll ME. On Diabetic Acidosis: a detailed study of electrolyte balances following the withdrawal and reestablishment of insulin therapy. J Clin Invest 1933; 12 (02) 297-326 6 Darrow DC, Pratt EL. Retention of water and electrolyte during recovery in a patient with diabetic acidosis. J Pediatr 1952; 41 (06) 688-696 7 Danowski TS, Peters JH, Rathbun JC, Quashnock JM, Greenman L. Studies in diabetic acidosis and coma, with particular emphasis on the retention of administered potassium. J Clin Invest 1949; 28: 1-9 8 Nguyen TQ, Maalouf NM, Sakhaee K, Moe OW. Comparison of insulin action on glucose versus potassium uptake in humans. Clin J Am Soc Nephrol 2011; 6 (07) 1533-1539 9 Aronson PS, Giebisch G. Effects of pH on potassium: new explanations for old observations. J Am Soc Nephrol 2011; 22 (11) 1981-1989 10 West ML, Magner PO, Richardson RM, Halperin ML. A renal mechanism limiting the degree of potassium loss in severely hyperglycemic patients. Am J Nephrol 1988; 8 (05) 373-378 11 Tattersall RB. A paper which changed clinical practice (slowly). Jacob Holler on potassium deficiency in diabetic acidosis (1946). Diabet Med 1999; 16 (12) 978-984 12 Carlotti AP, St George-Hyslop C, Bohn D, Halperin ML. Hypokalemia during treatment of diabetic ketoacidosis: clinical evidence for an aldosterone-like action of insulin. J Pediatr 2013; 163 (01) 207-12.e1 13 Gennari FJ. Hypokalemia. N Engl J Med 1998; 339 (07) 451-458 14 Ingram TC, Olsson JM. In brief: hypokalemia. Pediatr Rev 2008; 29 (09) e50-e51 15 Kim GH, Han JS. Therapeutic approach to hypokalemia. Nephron 2002; 92 (Suppl. 01) 28-32 16 Singhi S, Gautham KS, Lal A. Safety and efficacy of a concentrated potassium chloride solution infusion for rapid correction of hypokalemia. Indian Pediatr 1994; 31 (05) 565-569 17 Rimmer JM, Horn JF, Gennari FJ. Hyperkalemia as a complication of drug therapy. Arch Intern Med 1987; 147 (05) 867-869
